Author(s): COOMBS, C., PERRETT, C., GREEVES, J., O’LEARY, T., Institution: UK MINISTRY OF DEFENCE, Country: UNITED KINGDOM, Abstract-ID: 1684

INTRODUCTION:
Military roles are physically and psychologically demanding; energy intake may not always match high energy expenditures and Servicewomen may be at risk of outcomes associated with the Female Athlete Triad (Triad) and Relative Energy Deficiency in Sport (REDs) models. Chronic low energy availability may decrease physical performance through indirect endocrine effects—associated with menstrual disturbances—or direct effects such as under-fuelling. Whether markers of the Triad or REDs, including menstrual disturbances, eating disorders, and low energy availability are associated with physical performance in Servicewomen is unknown.
METHODS:
All women aged under 45 years in the British Army were invited to complete a custom-designed questionnaire that asked about: demographics, job role, risk of disordered eating (Brief Eating Disorder in Athletes Questionnaire), risk of low energy availability (Low Energy Availability in Females Questionnaire), training (military and personal), menstrual function, and physical performance (scores on military physical performance tests: 2 km run; deadlift). Physical performance was scored using British Army scoring categories. Inferential statistics were performed with ordinal logistic regression to assess the association of 2 km run time and maximal effort deadlift strength with the predictor variables: menstrual function, risk of eating disorders, and risk of low energy availability, when controlling for demographic factors and time spent physical training. Odds ratios represent the likelihood of moving from faster to slower run times or lighter to heavier lifts.
RESULTS:
1,341 women participated with 825 included following the exclusion of those pregnant or had not completed a military physical fitness test in the last 12 months. Menstrual disturbance (oligomenorrhoea/amenorrhoea vs eumenorrhea) (odds ratio [95% confidence intervals], 2 km run: 1.01 [0.62, 1.65], p = 0.962; deadlift: 0.86 [0.53, 1.40], p = 0.548), risk of an eating disorder (high vs low) (2 km run: 1.20 [0.79, 1.84], p = 0.392; deadlift: 1.01 [0.44, 1.68], p = 0.951), and risk of low energy availability (high vs low) (2 km time: 1.10 [0.83, 1.47], p = 0.496; deadlift strength: 1.33 [0.99, 1.78], p = 0.058) were not associated with run time or lift strength. Higher volumes of personal physical training (2 km run: 0.13 [0.08, 0.23], p < 0.001; deadlift: 4.46 [2.49, 8.08], p < 0.001) but not military physical training (2 km run: 0.71 [0.42, 1.21], p = 0.207; deadlift: 1.41 [0.81, 2.46], p = 0.218) (5 h·week-1 vs 0 h·week-1) were associated with better run time and lift strength.
CONCLUSION:
Military-specific physical performance was not associated with indicators of menstrual function, eating disorders, or low energy availability in Servicewomen. The pathophysiology of menstrual disturbances, eating disorders, and low energy availability in Servicewomen may be different to athletes and influenced by the multi-stressor environment.